A crippling case of red tape

Disabled man hit by welfare rules, doctors unwilling to sign notes

Bill Rockwell has been without disability benefits for two months because his doctor was away and he couldn't get an annual letter to prove he's still disabled. Photo Store

Bill Rockwell's chronic diabetes cost him his left leg last year when a foot infection turned into gangrene. While he was recovering in hospital, doctors discovered cancer in his chest.

Most recently, though, the wheelchair-bound man's most exasperating battle has been over a pile of welfare paperwork needed to prove he's still eligible for disability benefits.

"All I want to know is which one of these is not a disability?" said Rockwell, 55.

For the last two months, Rockwell has been living without his disability top-ups, which added about $200 to his basic $470 monthly welfare cheque. The top-up paid for a bus pass and a phone, and gave Rockwell extra cash for the high-protein diet recommended by his doctors. But, as of Jan. 15, that extra money stopped flowing because Rockwell couldn't find a doctor willing to fill out a bunch of forms.

"Right now, all I'm eating is macaroni and cheese out of a box, and that's not very good," said Rockwell, who volunteers at the West Broadway Community Ministry's daily drop-in. "Luckily, today we've got very good soup."

'It's a revolving door. They all want to pass the buck'

-- Bill Rockwell

Rockwell's troubles are symptomatic of the rigid rules poverty activists say overwhelm the welfare bureaucracy, the difficulty many poor people have getting good medical care and how hard it can be for low-income people to advocate for themselves.

The province is hoping to tackle some of those issues this year as part of a plan to modernize and simplify the welfare system, including the way it defines and helps people with chronic disabilities.

Rockwell's paperwork problems started Dec. 12, when welfare staff sent him a letter saying he needed to reapply for his disability top-ups, a process that requires a doctor to write two notes -- one for a phone and one for a bus pass -- and fill out a two-page form saying Rockwell's cancer and diabetes require a special high-protein diet.

Rockwell, who lives in Manitoba Housing, didn't get the notice from welfare until nearly the end of December. By then, Rockwell's family doctor was on holiday for weeks and no other doctor in the practice would see him.

Rockwell considered going to a walk-in clinic such as Four Rivers, but those often charge $20 for a doctor's note and Rockwell didn't have the cash. So, he missed the Jan. 15 deadline to submit all the paperwork and welfare slashed his benefits.

Rockwell was even in the hospital last month with frostbite, surrounded by doctors for a week, and none would fill out the form or write the notes.

"They said their doctors don't do that," said Rockwell. "I wasn't going to argue."

Meanwhile, his family doctor returned from holiday and referred Rockwell to a new doctor at Health Sciences Centre, who then referred Rockwell back to his old family doctor.

"It's a revolving door," said Rockwell. "They all want to pass the buck."

Lynne Somerville, a mentor at the West Broadway Community Ministry who works with welfare clients, said she sees many people in a similar bind. The province's welfare office requires people with chronic disabilities to prove every year they are still eligible for a bevy of top-ups for such things as medical supplies and better-quality groceries. It can be hard to find a doctor willing to fill out the proper forms, one of which is three pages long and often must be filled out every three or six months.

"They're becoming more and more rule-bound," said Somerville. "It's like something out of Charles Dickens."

Harold Dyck, another Winnipeg poverty activist, said about a quarter of the welfare recipients he advocates for have trouble with their disability paperwork and have seen their benefits suspended. Dyck said it can be hard for the poor to find a doctor willing to fill out forms and provide detailed notes that satisfy welfare staff, especially in the age of walk-in clinics with "one problem per visit" policies.

Forcing those who have chronic, long-term disabilities to get notes and forms from doctors over and over is a needless burden on the health-care system, added Dyck.

Rockwell's predicament came to the attention of NDP MLA Rob Altemeyer, and then landed on the desk of at least two cabinet ministers in recent days. Wednesday afternoon, Rockwell learned his benefits were being reinstated and he now has until June to provide the proper documentation. The process of getting Rockwell back on track was stymied by the fact welfare staff couldn't reach him because he no longer had a phone.

In recent years, reforms to Manitoba's welfare system have focused on getting recipients back to work, and that includes people with disabilities.

And, said the head of the province's welfare program, eligibility for certain benefits might change over time, meaning it's important to have some way to regularly review a disabled person's status.

"We're certainly aware of the balance that's needed between the legislative accountability and the need to support people," said Dave Fisher, executive director of the employment and income assistance program.

As part of the province's year-old strategy for sustainable employment, Fisher said this year, staff will begin looking at ways to simplify benefits for the disabled, especially those with severe and prolonged medical problems.

maryagnes.welch@freepress.mb.ca

Does the welfare system need to pare back the red tape? Join the conversation in the comments below.

DISABILITY WELFARE

There are about 30,000 adults in Manitoba on employment and income assistance, otherwise known as welfare. Well over two-thirds of welfare recipients are disabled and most get a top-up worth a couple hundred dollars a month for such things as a bus pass, a phone and higher-quality food. Here's a snapshot of the kinds of disabilities people on welfare have.

Intellectual: 5,980 people

Mental health: 9,350 people

Physical: 5,840 people

Other: 1,000 people

Note: Some people are in more than one disability category.

Source: Province of Manitoba, as of October 2013

PAPERWORK PREDICAMENT

Bill Rockwell needed two notes and a form from doctors to keep getting about $200 a month in extra disability benefits. Here are the details:

Appointment slips from a medical clinic or a note from an approved regulated health professional to confirm eligibility for a bus pass to be used for health transportation.

A note from an approved regulated health professional to confirm eligibility for a telephone needed in case of health emergencies.

The completion by an approved regulated health professional of a two-page form detailing the need for a therapeutic diet.

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